Active NPI
Brianna Willard
- Pharmacist
- San Jose, CA
National Provider Identifier
1427653856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 83504
- Practice address
- 4110 N 1St St
San Jose, CA 95134-1513 - Phone
- (408) 434-1839
- NPI assigned
- Dec 3, 2020
- Last updated
- Dec 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 83504 | CA | Primary |
Addresses
Primary practice location
4110 N 1St St
San Jose, CA 95134-1513
Mailing address
4337 Renaissance Dr Apt 321
San Jose, CA 95134-2809
Phone (781) 608-0082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83504 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1427653856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4337 RENAISSANCE DR APT 321",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951342809",
"telephone_number": "781-608-0082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4110 N 1ST ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951341513",
"telephone_number": "408-434-1839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLARD",
"first_name": "BRIANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-03",
"last_updated": "2020-12-03",
"certification_date": "2020-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "83504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.